Plasma Genotyping at the Time of Diagnostic Tissue Biopsy Decreases Time-to-Treatment in Patients With Advanced NSCLC-Results From a Prospective Pilot Study
© 2022 The Authors..
Introduction: The availability of targeted therapies has transformed the management of advanced NSCLC; however, most patients do not undergo guideline-recommended tumor genotyping. The impact of plasma-based next-generation sequencing (NGS) performed simultaneously with diagnostic biopsy in suspected advanced NSCLC has largely been unexplored.
Methods: We performed a prospective cohort study of patients with suspected advanced lung cancer on the basis of cross-sectional imaging results. Blood from the time of biopsy was sequenced using a commercially available 74-gene panel. The primary outcome measure was time to first-line systemic treatment compared with a retrospective cohort of consecutive patients with advanced NSCLC with reflex tissue NGS.
Results: We analyzed the NGS results from 110 patients with newly diagnosed advanced NSCLC: cohorts 1 and 2 included 55 patients each and were well balanced regarding baseline demographics. In cohort 1, plasma NGS identified therapeutically informative driver mutations in 32 patients (58%) (13 KRAS [five KRAS G12C], 13 EGFR, two ERRB2, two MET, one BRAF, one RET). The NGS results were available before the first oncology visit in 85% of cohort 1 versus 9% in cohort 2 (p < 0.0001), with more cohort 1 patients receiving a guideline-concordant treatment recommendation at this visit (74% versus 46%, p = 0.005). Time-to-treatment was significantly shorter in cohort 1 compared with cohort 2 (12 versus 20 d, p = 0.003), with a shorter time-to-treatment in patients with specific driver mutations (10 versus 19 d, p = 0.001).
Conclusions: Plasma-based NGS performed at the time of diagnostic biopsy in patients with suspected advanced NSCLC is associated with decreased time-to-treatment compared with usual care.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:3 |
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| Enthalten in: |
JTO clinical and research reports - 3(2022), 4 vom: 20. Apr., Seite 100301 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Thompson, Jeffrey C [VerfasserIn] |
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| Links: |
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| Themen: |
Circulating tumor DNA |
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| Anmerkungen: |
Date Revised 16.07.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.jtocrr.2022.100301 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM339223510 |
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| 100 | 1 | |a Thompson, Jeffrey C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Plasma Genotyping at the Time of Diagnostic Tissue Biopsy Decreases Time-to-Treatment in Patients With Advanced NSCLC-Results From a Prospective Pilot Study |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Revised 16.07.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2022 The Authors. | ||
| 520 | |a Introduction: The availability of targeted therapies has transformed the management of advanced NSCLC; however, most patients do not undergo guideline-recommended tumor genotyping. The impact of plasma-based next-generation sequencing (NGS) performed simultaneously with diagnostic biopsy in suspected advanced NSCLC has largely been unexplored | ||
| 520 | |a Methods: We performed a prospective cohort study of patients with suspected advanced lung cancer on the basis of cross-sectional imaging results. Blood from the time of biopsy was sequenced using a commercially available 74-gene panel. The primary outcome measure was time to first-line systemic treatment compared with a retrospective cohort of consecutive patients with advanced NSCLC with reflex tissue NGS | ||
| 520 | |a Results: We analyzed the NGS results from 110 patients with newly diagnosed advanced NSCLC: cohorts 1 and 2 included 55 patients each and were well balanced regarding baseline demographics. In cohort 1, plasma NGS identified therapeutically informative driver mutations in 32 patients (58%) (13 KRAS [five KRAS G12C], 13 EGFR, two ERRB2, two MET, one BRAF, one RET). The NGS results were available before the first oncology visit in 85% of cohort 1 versus 9% in cohort 2 (p < 0.0001), with more cohort 1 patients receiving a guideline-concordant treatment recommendation at this visit (74% versus 46%, p = 0.005). Time-to-treatment was significantly shorter in cohort 1 compared with cohort 2 (12 versus 20 d, p = 0.003), with a shorter time-to-treatment in patients with specific driver mutations (10 versus 19 d, p = 0.001) | ||
| 520 | |a Conclusions: Plasma-based NGS performed at the time of diagnostic biopsy in patients with suspected advanced NSCLC is associated with decreased time-to-treatment compared with usual care | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Circulating tumor DNA | |
| 650 | 4 | |a Lung cancer | |
| 650 | 4 | |a Lung cancer genomics | |
| 650 | 4 | |a Multidisciplinary | |
| 650 | 4 | |a Precision medicine | |
| 700 | 1 | |a Aggarwal, Charu |e verfasserin |4 aut | |
| 700 | 1 | |a Wong, Janeline |e verfasserin |4 aut | |
| 700 | 1 | |a Nimgaonkar, Vivek |e verfasserin |4 aut | |
| 700 | 1 | |a Hwang, Wei-Ting |e verfasserin |4 aut | |
| 700 | 1 | |a Andronov, Michelle |e verfasserin |4 aut | |
| 700 | 1 | |a Dibardino, David M |e verfasserin |4 aut | |
| 700 | 1 | |a Hutchinson, Christoph T |e verfasserin |4 aut | |
| 700 | 1 | |a Ma, Kevin C |e verfasserin |4 aut | |
| 700 | 1 | |a Lanfranco, Anthony |e verfasserin |4 aut | |
| 700 | 1 | |a Moon, Edmund |e verfasserin |4 aut | |
| 700 | 1 | |a Haas, Andrew R |e verfasserin |4 aut | |
| 700 | 1 | |a Singh, Aditi P |e verfasserin |4 aut | |
| 700 | 1 | |a Ciunci, Christine A |e verfasserin |4 aut | |
| 700 | 1 | |a Marmarelis, Melina |e verfasserin |4 aut | |
| 700 | 1 | |a D'Avella, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Cohen, Justine V |e verfasserin |4 aut | |
| 700 | 1 | |a Bauml, Joshua M |e verfasserin |4 aut | |
| 700 | 1 | |a Cohen, Roger B |e verfasserin |4 aut | |
| 700 | 1 | |a Langer, Corey J |e verfasserin |4 aut | |
| 700 | 1 | |a Vachani, Anil |e verfasserin |4 aut | |
| 700 | 1 | |a Carpenter, Erica L |e verfasserin |4 aut | |
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